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New York State Volunteer Ambulance and Rescue Association PO Box 254, East Schodack, NY 12063

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New York State Volunteer Ambulance and Rescue Association PO Box 254, East Schodack, NY 12063 New York State Volunteer Ambulance And Rescue Association PO Box 254, East Schodack, NY 12063 District 4, New York City Region PO Box 863991, Ridgewood, NY 11386 (718) 386-9651 FAX (718) 386-0925 E-mail: [email protected] Ryan Gunning, Chairperson ([email protected]) Martin Grillo, Vice Chairperson ([email protected]) Charles Hummel, Director ([email protected]) Janet Perry, Recording Secretary Nancy Ehrhardt, Treasurer Fran Serrentino, Financial Secretary THE PULSE October 2008 Chairperson's Message Day-to-day EMS mutual aid, as it is know everywhere else, no longer exists in New York City. FDNY EMS’s policy OGP 106-24 issued 11/18/04 on requesting outside assistance is based on system wide availability of ambulances below 25% for a sustained period and excessively high call volume. Neither sustained period or excessively high is defined. Under the policy, calls for emergency medical aid can be held indefinitely. If there is an available ambulance in Staten Island it will be sent to cover a call in midtown Manhattan regardless of response time. In the event of a need for outside resources the NYC REMSCO Disaster Mobilization Plan is invoked and a call goes out to have other agencies notify FDNY’s Resource Control Center of their availability. FDNY Operations Chiefs and the NYC OEM Watch Commander are notified and a mobilization point is designated. It is only then that mutual aid resources might be assigned to respond to a specific 911 call. This is not an arrangement meant to facilitate going outside the system. More to the point, the NYC REMSCO disaster plan was never meant to replace day-to-day mutual aid agreements signed by NYC Health and Hospital Corporation’s NYC*EMS and thought to be still in effect. NYS DOH has issued Policy Statements 95-04 and 95-09 indicating “EMS agencies have the responsibility to routinely provide the type and level of service … expected by the community”. Back in the 1970s such community expectations for ambulance service better than the 15 to 18 minute average response time by NYC*EMS were the impetus to start many of the volunteer services around the city. While current 911 System response times are in the high 7 to low 8 minute range there are many calls significantly exceeding the average that should be handed off to a mutual aid agency be it a private or volunteer service. No way is there a community expectation for a 911 ambulance in one borough to be sent to another borough while there is an available ambulance in that same community. Call, write, e-mail and/or visit your elected representatives, community boards, civic groups, local media and let them know that in these times of budget worries and limited resources options for better ambulance service in communities across the city are not being utilized. Congratulations are extended to NYC region individuals who received awards at PULSE CHECK: Joseph Marcellino, Flatlands VAC for EMS Leadership, Nadine Levick, MD, EMS Physician and Rosanne Murphy, RN, North Shore Rescue Squad as EMS Educator. Nancy Ehrhardt, Glen Oaks VAC received a President’s Award for her work as coeditor of the BLANKET newsletter. Ryan REGIONAL EMS COUNCIL OF NYC 2008 award nominations submitted to the NYS EMS Council were: • EMS Agency – North Shore Rescue Squad, Staten Island • EMS Leadership – Joseph Marcellino, MPH, EMT-P, Flatlands VAC • RN Professional Excellence – Rosanne Murphy, RN, EMT, North Shore Rescue Squad • Physician of Excellence – Nadine Levick, MD State EMS Council selections are announced at the NYS DOH sponsored VITAL SIGNS conference. REMSCO would like to be out of the picture as regards BLS First Responder agencies. However, NYS DOH policies require that BLSFR agencies seeking an agency code and its access to stated funded training must have recognition from their local EMS Council. A subcommittee consisting of representatives from the volunteer, private and municipal sectors has been established to review local policies on recognition. Martin Grillo, Vice Chair of District 4 is the volunteer representative. REMAC Elected as officers were: Lewis Marshall, MD, JD as Chairperson Joseph Bove, MD as 1st Vice Chairperson Heidi Corde, MD as 2nd Vice Chairperson Although a 9/23/08 report to REMSCO indicated REMAC reaffirmed its decision to longer support the EMT-CC level in the NYC Region there was no actual vote on the subject at the 9/16 REMAC meeting. There remains a possibility of continuing the level if enough support is demonstrated by interested squads. TRAINING & EDUCATION West Queens Emergency Medical Training Institute’s request to set up a training site in Brooklyn in the Wyckoff area was not approved. An alternate means of accommodating community groups with training in the area was suggested. St. Vincent’s Hospital Institute of Emergency Care was confirmed by the NYS DOH to have a course sponsorship area of the five boroughs of NYC. NYC REMSCO is still questioning the decision and is requesting copies of the documentation the DOH based its decision on. Barbara D’Amato notified the NYS DOH that she will be retiring her Center for Emergency Care Training. The center had course sponsorship authorization in Brooklyn and Queens. JOINT REGIONAL COUNCIL-REMAC QUALITY IMPROVEMENT COMMITTEE In order to promote best practices and improve pre-hospital medicine, two NYC region wide studies have been implemented for the period 10/01/08 through 12/31/08. All ambulance and ALS First Response agencies are required to participate. The studies are: - On-Scene Time for cardiac (non-arrest) and trauma (non-arrest) calls for both BLS and ALS units - Intra Osseous Access covering patient age & sex, access site, attempts, good flow in IV and type of IO equipment Notifications were sent to EMS agencies in the city in September and reports are due back to NYC REMSCO by 1/16/09. Data being reviewed indicates a 35% accuracy rate in 12 lead EKG interpretations by paramedics. GNYHA feels many patients not meeting STEMI criteria are being transported to STEMI centers. One possibility is ambulance crews trying to select the “best” hospital for their patients. Several training initiatives are being considered. FDNY NEWS A new 15 minute standard for on-scene evaluation and management of acute coronary syndrome patients has been established for NYC 911 System units. The goal is to ensure this patient type, particularly STEMI candidates, are evaluated and transported within 15 minutes of patient contact. ePCR data for May 2008 covering 173 cases indicates citywide on- scene time of 32.41 minutes. FDNY EMS will also be tracking on-scene time for several other patient categories comparable to the acute coronary syndrome patient including all chest pain patients, those with a presumptive diagnosis of acute stroke, patients who required On-Line Medical Control contact for ALS orders and trauma patients. The EMS Bargaining Unit composed of Locals 3621 & 2507 represented by a Chief Negotiator from District Council 37 has been meeting with NYC representatives. Over the course of negotiations, the City has presented the following to the EMS Bargaining Unit: • Proposed contract term of four years (7/1/06 through 8/23/10) with a 16% plus .25% gross increase. • Increase in welfare fund. • Expressed willingness to discuss a 12 hour tour pilot applicable to 1 division only but no sample work chart was given. • Proposal to establish subcommittee to improve pension benefits with cost to be born by employees and the city would provide support for any necessary legislation. • Proposal for pilot program for staffing ALS ambulances with 1 EMT and 1 EMT-P with 6% assignment differential and 12% after 1 year - medics only. • 12% specialty differential for Rescue Medics (Haz-Tac). A prior union response was that they would never agree to the 1 EMT-1EMT-P program. The unions also want to discuss what type of support the city proposes for pension increases and officers who are EMT-Ps. A panel of three arbitrators has been chosen with arbitration dates scheduled in January 2009. Talks on contract terms will continue. 50 new paramedics graduated on 7/2/08 at a ceremony at the Pfizer Auditorium at PolyTech University in Brooklyn. 21 paramedics and 101 EMTs graduated on 9/15/08 at a ceremony held at LaGuardia Community College. FDNY paramedic’s union issued a warning on 9/23/08 that FDNY ambulances on Staten Island and Queens are running dangerously low on several lifesaving drugs, particularly crucial heart medications. Etomidate, nitroglycerin, Cardizem, sodium bicarbonate and certain types of hypodermic needles were specifically mentioned. The Staten Island Advanced contacted FDNY and was told that there's nothing to worry about. "There are no shortages with regard to running out of medication," said an FDNY spokesman and he wouldn't comment further. By coincidence, also on 9/23 the city’s Budget Director ordered all city agencies to submit plans by 10/8 for cutting 2.5% in the fiscal 2009 budget year, which began July 1. An additional 5% cut is proposed for fiscal 2010, which begins 7/1/09. For FDNY it means $33.9M and $68M cuts. 8 hour tours by 911 system ambulances: ALS BLS Total ALS BLS Total 2006 Tours Tours Tours 2007 Tours Tours Tours October 311.3 599.7 911.0 October 316.9 595.9 912.8 November 314.6 598.7 913.3 November 317.1 592.9 910.0 December 321.4 602.2 923.6 December 332.1 600.8 932.0 2007 2008 January 320.2 612.0 932.3 January 335.3 609.2 944.5 February 319.7 610.1 929.8 February 332.7 596.6 929.2 March 320.7 597.0 917.7 March 332.1 595.6 927.7 April 319.9 601.3 921.3
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